One of the great pleasures of life, eating, becomes an ordeal with each bite. And we are not talking about fried and oily dishes. Not a simple avocado toast is saved from the gates of hell that your stomach becomes. Burning, belching or a bad taste in your mouth are the order of the day when you are a victim of gastroesophageal reflux (GER) . But we don't come to talk about him.
If these symptoms seem familiar to you, it may be that reflux is the sign of another medical condition . Dr. Antonio M. Moreno García, spokesman for the Spanish Foundation for the Digestive System (FEAD), tells us that if there is reflux when the medical history is taken, it is cause for suspicion of the existence of a hiatal hernia. A medical concept that sounds familiar to all of us but we don't quite know what it consists of or what its treatment is.
What is a hiatal hernia?
To make it clear to us what a hiatal hernia is, we must review the path that food takes after eating it . So, as if we were in a chapter of Once upon a time the human body, let's enter the mouth with our food and go down the esophagus (in the thorax) and then enter the stomach (this already in our abdomen). Here we make a stop, since the border between the thorax and the abdomen is the diaphragm muscle.
The key to everything is precisely in the door that the diaphragm has so that the esophagus and the stomach communicate. This door is the hiatus. So we have now reached the point where entanglement occurs. The hernia appears when through this door, through the hiatus, part of the stomach rises, leaving the area in which it is supposed to be.
Hiatal hernia appears when the stomach pokes out of the hiatus
Symptoms of hiatal hernia
Estimates are that 20% of the population may suffer from a hiatal hernia , being much more common among women. But, as Dr. Moreno García points out, in most cases "hiatal hernia does not produce symptoms." When the hiatal hernia has symptoms, "they are usually due to gastroesophageal reflux," he adds. It is for this reason that many patients never find out they have it or are diagnosed by chance.
Gastroesophageal reflux has become the king symptom, the almost infallible clue to suspect the existence of a hiatal hernia. In more than half of cases of reflux there is a hernia . But, beware, the ebb can exist by itself. They go together but they are not synonymous.
Stomach acids attack the esophagus
With a hiatal hernia, a retaining dam breaks. In the words of Moreno García, when the stomach passes through the hiatus to the thorax, "it makes it easier for the acidic content of the stomach to go back up, into the esophagus." The poor esophagus does not have the same tools as the stomach to protect itself from the acids of digestion , it becomes irritated and reflux occurs, with symptoms that turn food or its later hours into an ordeal. Symptoms that, on paper, are typical of reflux but that may indicate that it has been caused by a hiatal hernia.
- Burning. What is known as heartburn is suffered when the acid content irritates the walls of the esophagus, which causes discomfort in the pit of the stomach.
- Regurgitation Accompanied by a large number of burps after meals, a bad taste in the mouth and bad breath appear, which is why it has risen again.
- Swallowing problems Irritation of the lining of the esophagus can cause discomfort when swallowing solid foods.
- Aphonia. The vocal cords can be affected by acid irritation.
- Chest pain. If the burning sensation reaches high up the esophagus, the pain that is felt may be felt more in the chest than in the abdomen. This pain, depending on its intensity, can be confused with that caused by more serious ailments such as heart attacks. There are many other possible reasons for chest pain.
Causes of hiatal hernia
Although it is said that hiatal hernia can affect people of any age, if the little ones at home suffer it, it is a congenital defect of the hiatus itself and is usually more frequent after 50, when the diaphragm has weakened due to age .
But years of use are not the only causes of a weak diaphragm. There are a large number of conditions or pathologies that cause you to lose strength, many of them related to exerting strong and repeated pressure on the abdominal area.
- Overweight. Obesity leads to a growth in the volume of the abdomen. This increase can put pressure on organs such as the stomach, forcing their passage through the hiatus further.
- Constipation. If the problems of our intestinal flora force us to squeeze a lot when we go to the bathroom, this pressure in the abdomen also favors the displacement of the stomach. The same thing happens when you vomit continuously.
- Cough. When it becomes chronic, the constant effort of coughing takes its toll on our thorax, the other element that the diaphragm is responsible for separating.
- Pregnancy. The pressure of the uterus on the stomach favors the formation of the hiatal hernia. This opens the door to reflux and some of its symptoms, such as regurgitation and heartburn, can be included in the usual nausea and vomiting of the first trimesters.
Hiatal hernia: treatment
When you suspect that you may have a hiatal hernia, you should see your doctor. The one we have consulted makes it very clear that weight loss, taking care of our diet and the way we eat are essential. "If these measures are not enough, and with medical supervision, medications can be used."
Treatment, then, is focused on reducing stomach acidity . For example, with antacids that neutralize stomach acid or other medications that decrease or block acid production. Others also help heal the esophagus which, as we have already seen, is one of those that suffers the most with hernia.
Putting ourselves in the worst, when the reflux or burning does not improve with these medications or the esophagus has been greatly affected by heartburn, a surgical operation is required to solve the hiatal hernia.
Diet for hiatal hernia
If we look at the factors that have led the diaphragm and its hiatus to this situation, whether you have a hiatal hernia or if you have gotten rid of it for now and want to prevent, you have to improve nutrition as well as lifestyle habits . Forget tobacco and alcohol, lose weight and, in short, take care of what you eat but also how you eat it.
Hiatal hernia: prohibited and recommended foods
- Fats Avoid those foods that are high in fat like whole dairy or cream-based sauces. Excess oil and heavily processed foods fall into this category. Goodbye, too, to the cold cuts. And when it comes to cheeses, less cured and fresher.
- Vegetables and legumes. Let's keep those that produce a large number of gases at a safe distance. Cabbage, cauliflower or artichoke make our stomach work more. As for its first cousins, legumes, you have to cook them very well and take them in small quantities to also avoid the overexertion produced by gases. If you are concerned about excess gas, find out how much gas is too much.
- Acid and spicy. No foods that can irritate or have a high acid content. For example, vinegar or tomato. When it comes to fruits, citrus fruits are far away and bet on those that are well ripe or cooked in the oven or in compote.
- Meat and fish. As is also recommended in some weight loss diets, change fatty meats such as red or blue fish for lean ones such as turkey or chicken and white fish.
- Drinks. Tea, coffee, carbonated or alcoholic beverages cause increased gastric secretion. We can replace them with water or mild infusions. As we said a little above with fruits, watch out for the acidity of the juices.
In addition to the products that we put on our plate, the way in which we consume them, when and where is also important.
- Shape. First of all, change the chip and start cooking gently, steamed or baked.
- Temperature. Food should be eaten warm, since heat and cold can irritate the gastric mucosa.
- Weather. Eat every 2-3 hours and do not skip any food, better small and numerous than few and abundant. When you eat, do it little by little and sitting with your back straight.
Tricks to cope with a hiatal hernia
- Do not lie down. We started with a trick for right after eating. Wait about two hours before lying down, either to sleep your 8 hours or for a simple half-hour nap.
- Do not strain. Also avoid efforts that involve abdominal work such as bending over or carrying weight. We don't want to interrupt digestion when the area is so sensitive.
- Nothing tight. For the same reason, to take care of our abdomen and breathe correctly, do not wear tight clothes or belts or girdles.
- Don't sleep flat. When, finally, you can go to sleep, it would not be bad if you raised the head of the bed between 10 and 15 centimeters to be able to sleep in a more upright position. You can use the pillow under the mattress trick.
